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AANP Certification Exam-with 100%

verified solutions-2024- 2025

diverticulum can be an infection of both gram - and + bacteria Which diuretic should be used for osteoporosis? Thiazide diuretics: slows the kidneys excretion of calcium and increases reabsorption Lachman maneuver knee instability tear of ACL Infections of labia and vagina bacterial vaginosis, candidiasis, and trichomoniasis Chlamydia affects cervix, endometrial lining, fallopian tubes, pelvic cavity Acute abdomen symptoms involuntary guarding, rebound tenderness, board-like abdomen, +obturator and psoas sign Care of preecplampsia bed rest, weight and blood pressure monitoring Preeclampsia labs urine protein, serum protein, creatinine, platelet count Preeclampsia symptoms hypertension, proteinuria, edema (weight gain) Preeclampsia complications placental abruption, coagulopathy (DIC), renal failure, uteroplacental insufficiency, liver failure, hypertensive encephalopathy, retinal detachment, pulmonary edema, seizure, death

community acquired pneumonia Most common bacteria least common bacteria Population treatment mycolpasma pneumoniae (atypical) h. influenza, strep pneumoniae atypical: psuedomonas aeruginosa college student, school children, military macrolides: azithromycin, clarithromycin Mantoux test Positive: 5mm Positive for recent immigrants: 10mm Murphy's sign biliary disorders deep inspiration by patient and deep palpation RUQ below costovertebral angle placenta previa implantation of the placenta over the cervical opening or in the lower region of the uterus painless bright red blood in the second or third trimester Order abdominal US Hashimoto's is most common in which population middle age to older women Hypertension Retinopathy AV nicking and copper or silver wire arterioles flame-shaped hemorrhages threatened abortion vaginal bleeding and cramping, soft uterus, cervix closed bacterial vaginosis fishy odor, milky white or dull gray discharge pH > 4.

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KOH whiff test squamous cells dotted with lots of bacteria that obscure borders clue cells Lichen sclerosis skin disease, white spots appear over time, most common genital and rectal most common in older woman itching, discomfort, bleeding order biopsy AV valves mitral and tricuspid semilunar valves pulmonary and aortic S systole closure of AV valves mitral regurgitation aortic stenosis S diastole closure of semilunar valves mitral stenosis aortic regurgitation S normal variant in children, healthy young adults, and athletes heart failure early diastole S left ventricle hypertrophy late diastole

Tanner Stages Males: II no changes to penis, testes enlarge Pubic hair is sparse and straight Tanner Stages Males: III penis lengthens hair darker and starts to curl Tanner Stages Males: IV penis increases in length and width hair coarse, not yet on medial thigh Tanner Stages Females: II breast buds pubic hair sparse and straight Tanner Stages Females: III breast tissue and areola in one mound hair darker, starts to curl Tanner Stages Females: IV areola separates and forms a secondary mound hair coarse, not on medial thigh yet TORCH infections Toxoplasmosis Other Rubella Cytomegalovirus Herpes osteoarthritis vs rheomatoid arthritis OA: stiffness, heberden's nodes, increase age, overuse, family history RA: relies more on labs, increased ESR, Bouchard's nodes, fatigue, fever, body aches drawer test instability of the knee mediolateral and anteroposterior plane torn or ruptured ligament

fundal height 12 weeks just above pubic bone fundal height 20 weeks level of umbilicus fundal height 20-35 weeks number of weeks gestation +/- 2 cm apraxia loss of ability to perform purposeful movements in the absence of sensory or motor damage ectopic pregnancy amenorrhea, new onset of vaginal spotting, left adnexal tenderness, and cervical motion tenderness G6PD anemia hereditary, RBC break down, hemolysis Meds that can trigger: antimalarial drugs, aspirin, nitrofurantoin, NSAIDs, quinidine, quinine, sulfa Pheochromocytoma a benign tumor of the adrenal medulla that causes the gland to produce excess epinephrine and norepinephrine these hormones control heart rate, metabolism, and blood pressure Fitz-Hugh-Curtis Perihepatic inflammation & fibrosis; Complication of Chlamydia and pelvic inflammatory disease Sharp pain in RUQ subconjunctival hemorrhage risk factors Bright red patches in conjunctiva of eyes due to ruptured blood vessels Risk factors: DM, HTN, coughing, sneezing, blood thinners, aspirin, ginkgo Benign, will spontaneously resolve

atopic dermatitis Excess inflammation; dry skin, redness, and itching from allergies and irritants. linear Koplik spots Rubeola (measles) small white papules inside the cheeks by rear molars treponema pallidum symptoms syphilis painless chancre, maculopapular rash on palms and soles, lymphadenopathy, condyloma acata hCG is produced by placenta after implantation majority of AFP is produced by fetal liver Inevitable abortion bleeding and cramping/pain with cervical dilation but no passage of tissue incomplete abortion moderate to diffuse vaginal bleeding, passage of tissue, painful uterine cramping or contractions MMR and pregnancy contraindicated wait 4 weeks before becoming pregnant Positive signs of pregnancy ultrasound, auscultation of fetal HR with doppler Probable signs of pregnancy detected by examiner blood and urine tests, Chadwick's sign, Goodell's sign, Hegar's sign, enlarged uterus

Presumptive signs of pregnancy felt by woman amenorrhea, nausea, breast tenderness, deepening pigmentation, urinary frequency, quickening, fatigue testing HPV lesions will turn white with application of acetic acid OCD treatment SSRI first step for dementia assessment history from family and friends Phalen maneuver Tests carpel tunnel syndrome, pinches median nerve chronic cough causes postnasal drip, asthma, GERD, chronic bronchitis, bronchiectasis, allergic rhinitis Aspirin effect on platelets irreversible, can last 15-20 days Chromolyn sodium inhaler prevent symptoms of asthma Rovsign's sign acute abdomen palpate deep LLQ, referred pain to RLQ cauda equina caused by compression of lumbar, sacral, or coccygeal nerve roots loss of bladder and bowel control paralysis/numbness of legs cause: disc herniation. abscess, tumor, inflammation order MRI

placenta abruptio premature separation of the placenta from the wall of the uterus bright red vaginal bleeding, board-like uterus on palpation, pain Jarisch-Herxheimer reaction Flu-like syndrome (fever, chills, headache, myalgia) after antibiotics are started; due to killed bacteria (usually spirochetes) releasing endotoxins. Treatment of syphilis, first 24 hours headache, myalgias, rigors, sweating, hypotension, worsening of rash spontaneously resolves in 12-24 hours coarctation of the aorta congenital cardiac condition characterized by a narrowing of the aorta blood pressure higher in arms than legs mitral valve prolapse improper closure of the mitral valve late systolic murmur in the apical area mid-systolic click pterygium triangular opaque tissue on the nasal side of the conjunctiva that grows toward the center of the cornea cause by long-term sun exposure corneal arcus senilis Lipid deposits in the periphery of the eye white to grey colored ring around the edge of the cornea in both eyes pingeucula benign growth on the conjunctiva caused by degeneration of collagen fibers cause by long-term sun exposure Lyme disease Tick-borne disease caused by the spirochete Borrelia burgdorferi. erythema migrans treat with doxycycline

Epstein-Barr virus labs infectious mononucleosis triad: fever, pharyngitis, lymphadenopathy normal to moderate WBCs, increased lymphocytes, >10% atypical lymphocytes Cafe au lait spots Smooth edged tan-to-brown pigmentations on the skin seen in neurofibromatosis or von Recklinghausen's papilledema swelling of the optic disc caused by increased ICP usually bilateral enlarged blind spot on visual field test Fundoscopic exam The use of an ophthalmoscope to look through the pupil and examine the interior surface of the posterior eye visualizes vessels and assess intracranial tension recommended for new onset headache fundoscopic exam red reflex exam used to assess for cataracts Leukoplakia thickened, white, leathery-looking spots on the inside of the mouth from chronic tobacco use retinoblastoma fundoscopic exam white reflection on pupil high vitamin K levels effect with coumadin decrease INR HELLP syndrome hemolysis, elevated liver enzymes, low platelets

complication of preeclampsia multipara, >25, 3rd trimester RUQ pain, n/v, malaise low H/H low AFP Down syndrome order triple screen high AFP indicates neural tube defects, multiple gestation order triple screen or sonogram HCG doubles every 48 hours during the first 12 weeks ectopic pregnancy HCG level lower levels inevitable abortion HCG level starts decreasing rapidly drawer sign knee instability, torn/ruptured ligament anterior: ACL posterior: PCL Finklestein's test Test for de Quervain's syndrome McMurray Test medial meniscus hear a click acute angle closure glaucoma sudden unilateral eye pain, redness, dilated oval shaped pupil with poor light response headache, n/v, halos around lights cloudy cornea

fundoscope: cupping of optic nerve optic neuritis new-intermittent loss of vision in 1 eye nystagmus multiple sclerosis orbital cellulitis Redness, swelling, impaired motility, painful, proptosis retinal detachment floaters and flashes of light, curtain vision diabetic retinopathy Microaneurysms caused by new fragile arteries in the retina. cotton wool spots cataracts opacity of lens, halos around lights, develop slowly over time, causing symptoms such as blurry vision Fibromyalgia symptoms last more than 3 months diffuse pain, sleep abnormalities, fatigue Alzheimer's symptoms aphasia, apraxia, agnosia Mini-Mental State Examination (MMSE) mid-moderate score 10- Mini-Mental State Examination (MMSE) moderate-advanced score <